DESCRIPTION: (Applicant's Abstract) Cognitive Behavioral Stress Management (CBSM) is an intervention developed by our project team during over a decade of NIH-funded research to address the unique primary and secondary prevention issues of the HIV+ population. This proposed 5-year study is designed to evaluate the effects of an adapted version of this intervention, CBSM-RDA, aimed at the unique needs of HIV+ recovering drug abusers (RDAs) and the ethnic/cultural factors that may mediate outcome. In particular, this study heeds the national priority on translational research and adaptation of proven interventions to benefit minority HIV+ subgroups, who are culturally different, less affluent, and who bear the added burden of a history of drug abuse and the special needs of recovery. Because this is a grossly understudied population, especially with regard to CART adherence (Combination Antiretroviral Therapy), a key aim of this study is to focus CBSM-RDA on improving medication adherence and on understand the trajectories of success due to our intervention. We propose a randomized clinical trial to test relative effects of CBSM-RDA and a Health Promotion Comparison (HPQ condition, designed to be structurally equivalent in time, attention, and interest value. Employing a 2 (CBSM-RDA vs. HPQ) x 5 (pre-, post-intervention, 4, 8, and 12-month follow-up assessments) design, we will provide the intervention to a culturally diverse, predominantly minority population of HIV+ RDA men (N= 160) and women (N= 160) and comparatively assess the therapeutic effects of CBSM-RDA and HPC on key endpoints: distress and quality of life, drug abuse relapse, unsafe sex, CART adherence, and health status. Another key motivation of this research is to specify the mediators and moderators of these endpoints to address issues of mechanism of action and generalizability, respectively. Hierarchical Linear & Structural Equations Modeling will be used to explore how study variables interrelate to predict outcome. If successful, this research will provide important new intervention strategies that can be practically implemented with HIV+ drug abusers.